title: Emotional modulation of pain and spinal nociception in persons with severe insomnia symptoms.
abstract: BACKGROUND
  Impaired sleep enhances pain, perhaps by disrupting pain modulation.
  
  
  OBJECTIVE
  Given that emotion modulates pain, the present study examined whether emotional modulation of pain and nociception is impaired in persons with severe insomnia symptoms relative to controls.
  
  
  METHODS
  Insomnia group (n = 12) met the International Classification of Diseases, tenth revision symptoms for primary insomnia and controls (n = 13) reported no sleep impairment. Participants were shown emotionally evocative pictures (mutilation, neutral, and erotica) during which suprathreshold pain stimuli were delivered to evoke pain and the nociceptive flexion reflex (NFR; physiological correlate of spinal nociception).
  
  
  RESULTS
  Emotional responses to pictures were similar in both groups, except that subjective valence/pleasure ratings were blunted in insomnia. Emotional modulation of pain and NFR was observed in controls, but only emotional modulation of NFR was observed in insomnia.
  
  
  CONCLUSIONS
  Consistent with previous findings, pain modulation is disrupted in insomnia, which might promote pain. This may stem from disrupted supraspinal circuits not disrupted brain-to-spinal cord circuits.
authors.affiliation: Department of Psychology, The University of Tulsa, 800 South Tucker Drive, Tulsa, OK, 74104, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: DelVentura
authors.forename: Ellen L
authors.initials: EL
authors.lastname: Terry
authors.forename: Emily J
authors.initials: EJ
authors.lastname: Bartley
authors.forename: Jamie L
authors.initials: JL
authors.lastname: Rhudy
mesh_terms: D000293:Adolescent; D000328:Adult; D001143:Arousal / Q000502:physiology; D016022:Case-Control Studies; D004576:Electromyography; D004644:Emotions / Q000502:physiology*; D005149:Facial Expression; D005221:Fatigue / Q000150:complications / Q000503:physiopathology / Q000523:psychology; D005260:Female; D005712:Galvanic Skin Response / Q000502:physiology; D006304:Health Status; D006801:Humans; D008297:Male; D059225:Nociception; D010146:Pain / Q000150:complications* / Q000503:physiopathology / Q000523:psychology*; D017288:Pain Threshold / Q000502:physiology / Q000523:psychology; D010775:Photic Stimulation; D013216:Reflex, Startle / Q000502:physiology; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications* / Q000503:physiopathology / Q000523:psychology*; D013116:Spinal Cord / Q000503:physiopathology*; D055815:Young Adult